From the Guidelines
Radiofrequency ablation (RFA) does not necessarily work best with more treatments, as the effectiveness of RFA is highly dependent on the size and location of the tumor, as well as individual patient factors. The most recent and highest quality study, published in 2024 1, suggests that RFA can achieve comparable survival rates to surgical resection in selected patients, with complete response rates between 70 and 90% significantly linked to improved overall survival. However, the 5-year recurrence rate after RFA can reach 50–70%, with incomplete ablation particularly problematic for irregular lesions or in the presence of intrahepatic metastasis, multicenter recurrence, and small satellite nodules. Some key points to consider when evaluating the effectiveness of RFA include:
- Tumor size and location: RFA is most effective for tumors less than 5 cm in size, and location can impact the ability to achieve complete ablation.
- Patient selection: RFA is typically recommended for patients with early-stage hepatocellular carcinoma (HCC) who are not suitable for surgical resection.
- Technical considerations: The use of multipolar RFA and combination with other treatments, such as transarterial chemoembolization, may improve outcomes.
- Follow-up and monitoring: Regular follow-up and monitoring are crucial to detect any signs of recurrence or incomplete ablation. It's also important to note that RFA has advantages over surgical resection, including lower complication rates and minimal damage to surrounding healthy liver tissue, thereby preserving more viable liver tissue 1. Ultimately, the decision to use RFA and the frequency of treatments should be determined by a healthcare provider based on individual patient factors and response to initial therapy.
From the Research
Radiofrequency Ablation (RFA) Treatment Efficacy
- The efficacy of RFA can depend on various factors, including tumor size, location, and the number of treatments 2, 3, 4.
- Studies have shown that RFA can be an effective treatment option for patients with localized breast cancer who decline surgery or are not candidates for surgery 2.
- For patients with non-small cell lung cancer, RFA may be a valuable salvage tool to achieve local tumor control, especially in tumors measuring <3 cm in size 3.
Multiple RFA Treatments
- There is limited evidence to suggest that multiple RFA treatments are more effective than a single treatment 5, 6.
- A study on patients with unresectable liver metastases from colorectal cancer found that RFA can contribute to encouraging long-term survival, particularly when offered as part of first-line therapy 6.
- Another study on patients with inoperable non-small cell lung cancer found that the combination of RFA with external beam radiation therapy appears feasible with favorable long-term local control, but does not recommend routine combined RFA and EBRT 5.
Tumor Size and RFA Efficacy
- Tumor size is an important factor in determining the efficacy of RFA, with smaller tumors (<3 cm) tend to have better outcomes than larger tumors 3, 4.
- A study on patients with breast cancer found that the ablated zone extended around the RF electrode for a diameter of 0.8 to 1.8 cm, suggesting that RFA may be more effective for smaller tumors 4.